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D.A. John, A. Rahman, K.M. Joos; Diagonal Earlobe Crease Prevalence in a Glaucoma Patient Sample . Invest. Ophthalmol. Vis. Sci. 2003;44(13):4374.
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Purpose: Decreased blood supply is considered to contribute significantly to the pathogenesis of the diagonal earlobe crease. Because blood flow abnormalities may be a factor in glaucoma, we investigated whether diagonal earlobe creases are associated with a glaucoma diagnosis. Methods: During a 1 month study period, 396 adult glaucoma clinic patients and control significant others presenting to the Vanderbilt Glaucoma Service consented to an earlobe crease evaluation. Patients were grouped according to their glaucoma diagnosis. Each participant was assigned an earlobe crease score based on the diagonal earlobe scale developed by S.T. Frank (Frank’s sign). Descriptive statistics and Spearman Rank Order Correlations were performed. Results: A positive relationship between increasing age and the presence of the earlobe crease was shown with all participants involved in the study (p<0.001). A positive correlation between increasing age and the diagonal earlobe crease was demonstrated also in the following subgroups: controls (n=106, p=0.002), all glaucoma clinic patients (n=290, p<0.001), glaucoma suspect (n=21, p<0.001), ocular hypertension (n=18, p=0.026), chronic open angle glaucoma (n=139, p<0.001), pigmentary glaucoma (n=16, p=0.015), and congenital/juvenile glaucoma (n=7, p=0.04). Only patients with a diagnosis of pseudoexfoliation glaucoma (n=11) had 100% prevalence of a diagonal earlobe crease. However, this subgroup had the greatest mean age (73.8+7.1 years). Conclusions: Overall, earlobe crease presence is correlated with increasing age in glaucoma and control subjects. Interestingly, all 11 pseudoexfoliation glaucoma subjects had an earlobe crease that may warrant further investigation. Their advanced mean age in this study may be a causative factor.
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